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General NPI Number Information
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NPI Number | 1427531425
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Entity Type | Organization
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Legal Business Name | BRIAN J MCKINNEY, MD INC.
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Dates
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Enumeration Date | 09/14/2018
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Last Update Date | 09/14/2018
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Provider Practice Location Address
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Address Line | 333 SKYWAY DR
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City | CAMARILLO
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State | CA
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Zip | 93010-8552
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Country | US
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Telephone | 805-383-1155
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Fax | 805-383-1134
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Provider Business Mailing Address
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Address Line | 2945 TOWNSGATE RD STE 200
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City | WESTLAKE VILLAGE
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State | CA
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Zip | 91361-5866
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Country | US
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Telephone | 714-697-2888
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN MCKINNEY
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Credential | MD
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Telephone | 714-697-2888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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